VA Health Care: More Veterans Are Being Served, but Better Oversight Is Needed
HEHS-98-226
Published: Aug 28, 1998. Publicly Released: Aug 28, 1998.
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Highlights
Pursuant to a legislative requirement, GAO reviewed the: (1) changes in overall access to care, changes in access to certain specialized services, and a comparison of changes in Veterans Integrated Service Network (VISN) 3 (Bronx) and VISN 4 (Pittsburgh) with Department of Veterans Affairs (VA) national data from fiscal years (FY) 1995 to 1997; (2) extent to which VA headquarters and VISNs are working to equitably allocate resources to facilities within VISNs; and (3) adequacy of VA's oversight of changes in access to care.
Recommendations
Recommendations for Executive Action
| Agency Affected | Recommendation | Status |
|---|---|---|
| Department of Veterans Affairs | The Secretary of Veterans Affairs should direct the Undersecretary of Health to develop uniform definitions and institute timely reporting of changes in access to care, including the number and eligibility priority of patients served, waiting times for care, and patient satisfaction for specific services at the VISN and facility level. |
VA has implemented indicators of clinic waiting times to measure timeliness and access at to care at both the network and facility level. VA implemented waiting times for next available appointments in February, 2000. In February 2001 VA added additional waiting time indicators to provide management with other ways of measuring timeliness and access. These include average waiting time for all appointments, average waiting time for new patients, and average waiting time for established patients. In addition, VA has implemented other measures such as proportion of discharges to non-institutional settings from spinal cord injury and domiciliary care. Also VA has implemented measures of spinal cord injury care patients' rating of their inpatient and outpatient care.
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| Department of Veterans Affairs | The Secretary of Veterans Affairs should direct the Undersecretary of Health to develop criteria for equitably allocating resources to facilities and monitor any improvements in equity of access among and within VISNs. |
As previously reported, VA revised its Directive 97-054 to its health care networks regarding their allocation of resources to facilities. The revision states that each network allocation model will support the goal of improving equitable access to care and ensure appropriate allocation of resources to meet that goal. This revision was incorporated into the directive in final on November 19, 1998. VA has been measuring clinic waiting times since Feb, 2000 and added more waiting time indicators in Feb 2001 that provide information at the network and facility level. This provides VA information for using in accessing the impact of resource allocation on equitable access within and between networks.
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Federal agency reorganizationHealth care cost controlHealth care programsHealth resources utilizationHealth services administrationPatient care servicesVeteransVeterans benefitsVeterans hospitalsAccess to health care